PUBLIC UTILITY DISTRICT NO. 1 of Whatcom County 2019 Small Works Roster Application for Qualification

Transcription

1 PUBLIC UTILITY DISTRICT NO. 1 of Whatcom County 2019 Small Works Roster Contractors whose names appear on the Roster may submit job proposals for contracts in the amount of less than three hundred thousand dollars ($300,000) per RCW & To be considered by Whatcom PUD and approved to be included on Whatcom PUD s Small Works Roster each contractor shall: be a responsible bidder as defined by current Washington State Law; have a current Certificate of Registration as a Contractor in the State of Washington; a current Washington State Unified Business Identifier number; and if applicable; Industrial Insurance coverage for the applicant s employees working in the State of Washington; an Employment Security Department number; a Washington State Excise Tax registration number; have a Workmen s Compensation Experience Factor equal to or less than one (1.0); have the ability to bond projects in the amount of $300,000 or less; have personnel with a minimum of five (5) years experience in the trade or scope of work indicated in the Application; be able to submit a Certificate of Insurance for the minimum amounts indicated in the Application, and if needed have satisfactory qualifications to receive Safety Training and Security Clearances from Whatcom PUD s industrial customers. In addition, the bidder must not be disqualified from bidding on any public works contract under RCW or (3). The law requires that public owners verify the items prior to award of a public works contract. RCW requires that public works contractors and subcontractors verify that any subcontractors they directly hire meet the responsibility criteria for the project at the time of the subcontract execution. Contractor Information Name of Firm:... Address:... City, State and Zip Code:... Phone No.:... Fax No.:... Address:... Check as Appropriate:...[ ] Incorporated [ ] Partnership [ ] Sole Proprietorship WA Contractor s License No.:... Please attach copy of Contractor s License with this Application WA State Unified Business Identifier (UBI) No.:... WA State Employment Security Department No.:... WA State Excise Tax Registration No.: Workmen s Compensation Experience Factor:... Number of years Applicant has been completing work as identified hereafter: Application Signed By: Printed Name: Title: Date: Whatcom PUD APPROVAL:... Granted Denied --- By: Title: Date: 2019 Small Works Roster - 1

2 Planned Emergency Classifications/Descriptions of Work: Maintenance/Project Response ELECTRICAL UTILITY ** Transmission Line Construction, Maintenance & Repair (115 kv) Electrical Equipment Installation (2.4 kv, 5kV & 480V) Electrical Equipment Maintenance & Repair (2.4 kv, 5kV & 480V) Vegetation Management; Brush Clearing, Field Mowing Vegetation Management, Tree Falling & Removal Electrical Equipment Installation (115 kv) Electrical Equipment Maintenance and Repair (115 kv) Electrical Motor Maintenance & Repair (> 100hp) Electrical Motor Maintenance & Repair (< 100hp) Environmental: Clean up, hazardous waste, oil spills Other Electrical Utility Specialty Work Not Listed Above: Project(s) planned & budgeted to be completed in ** For Electrical Utility Work on voltages greater than 750 Volts, Washington State Law requires Electrical Contractors to complete an additional Pre-Qualification Form and be approved by Whatcom PUD. The Pre- Qualification is separate from this Small Works Roster. If completing this application for Electrical Utility Work please request from Whatcom PUD the additional Pre-Qualification Form Small Works Roster - 2

3 Planned Emergency Classifications/Descriptions of Work: Maintenance/Project Response WATER UTILITY Waterline Installation and Repair Waterline (4 24 ) Installation, Maintenance & Repair Water Service (1/2 12 ) Installation, Maintenance & Repair Water Meter (5/8 24 ) Installation, Maintenance & Repair Water System Valve (16 24 ) Installation, Maintenance & Repair Fire Hydrant Installation, Maintenance & Repair Distribution System Maintenance & Repair Distribution System Test Station Installation, Maintenance & Repair Other Waterline Specialty Work Not Listed Above: Pump Maintenance and Repair Well Pump Installation, Maintenance & Repair Centrifugal Pump Installation, Maintenance & Repair Pressure Gauge Saddle Tap & Installation Diesel Engine Maintenance & Repair Air Compressor Maintenance & Repair Other Pump Specialty Work Not Listed Above: Clarification Plant Maintenance and Repair Clarification Plant Mechanical Installations, Maintenance & Repair General Building Construction, Maintenance & Repair Other Clarification Specialty Work Not Listed Above: Project(s) planned & budgeted to be completed in Small Works Roster - 3

4 Planned Emergency Classifications/Descriptions of Work: Maintenance/Project Response GENERAL FACILITY Facility Maintenance & Specialty Work: Vegetation Management; Brush Clearing, Field Mowing Vegetation Management; Tree Falling & Stump Removal Vegetation Management; Chip & Grind Other General Facility Specialty Work Not Listed Above: General Building Construction & Repair Gate & Fencing, Installation, Maintenance & Repair General Building Construction, Maintenance & Repair Commercial Painting Buildings (exterior, interior, etc.) HVAC Maintenance & Repair Commercial Roofing, Buildings Earthwork (excavation, fill & grading) Asphalt Roadway, Installation & Repair Structural Concrete Placement & Repair: Horizontal Placement: Form/Reinforcement/Pour/Strip/etc Vertical Placement: Form/Reinforcement/Pour/Strip/etc Structural Metal Fabrication: Design/Fabrication/Welding/Installation Design/Fabrication/Welding/Installation Other General Building Construction and Repair Specialty Work Not Listed Above: Project(s) planned & budgeted to be completed in STANDARD SPECIFICATIONS The 2018 or most current edition Standard Specifications for Road, Bridge, and Municipal Construction (WSDOT) Division 1 General Requirements are hereby referenced as the Standard Specifications for all Projects and/or Work that will be administered by Whatcom PUD under the 2019 Small Works Roster Small Works Roster - 4

5 INSURANCE REQUIREMENTS The following insurance information and limits are included in this Application for REFERENCE ONLY. Each project will have in it s Specifications and General Conditions specific insurance requirements as applicable to the work considered. It is not anticipated that the limits for future projects will exceed those identified below. 1. Commercial General Liability Bodily Injury and Property Damage $1,000,000. General Aggregate $1,000,000. Products & Completed Operations Aggregate $1,000,000. Personal & Advertising Injury $1,000,000. Each Occurrence $50,000. Fire Damage Stop Gap Employers Liability $1,000,000. Each Accident $1,000,000. Disease Policy Limit $1,000,000. Disease Each Employee 2. Commercial Automobile Liability Bodily Injury and Property Damage $1,000,000. Combined Single Limit 3. Excess or Umbrella Liability $1,000,000. Per Occurrence and Aggregate 4. Pollution Liability $1,000,000. Per Occurrence 5. Professional Liability $1,000,000. Per Claim and Annual Aggregate 6. Worker s Compensation As required by the Industrial Insurance Laws of the State of Washington. The policy of insurance shall specifically name the Contracting Agency and any other entity specifically required by the Contract Provisions as an additional insured. The Contracting Agency shall be given 45 days prior written notice of any cancellation, reduction or modification of the insurance. The following shall be named as additionally insured for this Project: Public Utility District No. 1 of Whatcom County Please return completed Application to: Public Utility District No. 1 of Whatcom County P O Box 2308 Ferndale, WA Attn: Alec Strand, Project Manager All applications shall be completed and returned to Whatcom PUD by 30 January 2019, to assure inclusion in the 2019 Roster, although Whatcom PUD will accept applications throughout the year. Whatcom PUD will provide written confirmation to the applicant as to the status of the application (approval or denial). The Roster shall be in effect through 31 December 2019 and will be updated on an annual basis Small Works Roster - 5

6 AVAILABILITY OF COVERAGE [Please have your Bonding Agent/Company fill out this form. If your company is selected to enter into a contract with Whatcom PUD, then at that time, Bonding and Insurance will be required.] 1. BONDING: I/we, hereinafter called "Surety", hereby certify(ies) that, hereinafter called "Contractor", is covered by this Surety and has the capacity to be bonded for performance and payment of contract work with Public Utility District No. 1 of Whatcom County, Washington in the amount not to exceed: Three Hundred Thousand dollars ($300,000.00). By: Its: Address & Phone Number of local office and agent... Address & Phone Number of Surety Small Works Roster - 6

7 AVAILABILITY OF COVERAGE [Please have your Insurance Agent/Company fill out this form. If your company is selected to enter into a contract with Whatcom PUD, then at that time, Bonding and Insurance will be required.] 2. INSURANCE: I/we, hereinafter called "Insurer", hereby certify(ies) that, hereinafter called "Contractor", is insured by this Insurer and can be covered to the following: a. Public Liability Insurance in an amount not less than one million dollars ($1,000,000) combined single limit per occurrence for bodily injuries and death and/or property damage. b. Property Damage Insurance in an amount not less than one million dollars ($1,000,000) per any one occurrence. c. If any structures are involved in the contract, the Contractor shall provide property insurance under an All Risk Builder s Risk form in an amount equal to the value of the structure. The structure shall have All Risk Builders Risk Insurance inclusive of earthquake and flood subject to customary industry deductibles. By: Its: Address & Phone Number of local office and agent... Address & Phone Number of Insurer Small Works Roster - 7

8 Prevailing Wages The Contractor and its Subcontractors shall comply with all requirements of the Washington State Prevailing Wage Laws, RCW Every Contractor and Subcontractor on every public works project must file a Statement of Intent to Pay Prevailing Wages and an Affidavit of Wages Paid. Both forms must be filed on every project. The filing of the Affidavit of Wages Paid does not set aside the requirements to also file the Statement of Intent to Pay Prevailing Wages. Payment for Work completed by the Contractor and/or Subcontractor(s) may be delayed until such time that all required Prevailing Wage forms have been submitted to and approved by the Department of Labor and Industries and received by Whatcom PUD. Forms Required for Consideration of Small Works Roster Complete Signed Whatcom PUD Small Works Application... Copy of current State of Washington Business License... Copy of current State of Washington Contractors License... Signed Availability of Bonding Coverage... Signed Availability of Insurance Coverage Small Works Roster - 8